Soft tissue structures, such a ligaments and tendons, connect multiple anatomic components together. Whether the connection is bone-to-bone, muscle-to-bone, or some other linkage, these soft tissue structures are often, if not permanently, subject to tension forces. Injuries can partially or completely sever such structures leading to immobility and/or dysfunction of the anatomic components. In one example, a shoulder injury may tear a portion of the rotator cuff from its connection to bone, leading to instability of the shoulder joint and causing the naturally tensioned tendon to slacken.
In some instances surgery may be needed to repair or replace the damaged soft tissue structure, which often involves pulling the native soft tissue or a soft tissue graft into a natural state of tension and into a position for healing. Maintaining the soft tissue in a healing position and in a constant and consistent state of tension may be beneficial in allowing the soft tissue to heal as closely to a natural state as possible and to prevent any healing progress from becoming undone.
Generally, an anchoring support and, optionally, a filament attached to the anchoring support are utilized in soft tissue reparation. A recent trend in tissue anchor and suture anchor devices is the “soft” device, also referred to as a “filamentary” fixation device, in which the device itself is constructed of a filamentary material, such as suture or the like. Such filamentary fixation devices can replace traditional metal or hard polymer devices in numerous soft tissue repair and replacement surgical procedures. Such filamentary fixation devices may provide solutions to various problems encountered with traditional metal or hard polymer devices. In many instances, such traditional devices tend to be large in diameter, and must include sufficient material, or other additional structures, to withstand the forces pulling against the device, whether via a suture or directly against the device itself. The size of such devices may limit the possible implantation locations in the body, as sufficient bone mass is required to accommodate the device. Moreover, a large hole must be drilled into the bone to allow for passage of the device through the cortical layer and into the cancellous bone. The larger drill holes may be too invasive resulting in excessive loss of healthy bone, or creation of a large repair site.
Despite the many benefits these filamentary fixation devices provide, such devices can benefit from alternative filament securement techniques as securing the filament is often the major difficulty faced when using such filamentary fixation devices.